Considering Control-IQ? Why I Made the Switch
Cherise Shockley shares how she decided to switch from DIY Loop to Control-IQ, and what she learned along the way.
Having lived with diabetes for 17 years, I have a long history with insulin injections and insulin pumps. After many years, I thought I’d really found my groove and found myself sticking with the Omnipod patch pump because it’s tubeless and comes with top-notch customer service. But the older I get, the more I find I’m on a constant journey to find better strategies for managing my diabetes.
In 2019, I noticed more significant swings in my blood sugar levels, which I attributed to stress and weight gain. My insulin needs went up, and I found I had to adjust the settings on my Omnipod pump system more often to match changes in my insulin sensitivity. This was taking a lot out of me, and I considered giving up on a pump entirely. As a matter of fact, I had taken a pump break, and I wasn’t sure I could go back. After reading and hearing success stories about Looping, an automated insulin delivery (AID) system that could be tailored to my needs, from the diabetes online community and from my close friends, I decided to give it a try.
To automate insulin delivery, Loop combines an insulin pump (in my case, an Omnipod Eros System), a Dexcom continuous glucose monitor (CGM), an iPhone, and a Riley Link transmitter – a small device that enables the iPhone and the pump to communicate. Loop is not yet FDA-approved. It’s an experimental, open-source computer algorithm that anyone can download for free to help streamline their diabetes management. To learn more about Loop, check out our “How I Loop” series.
Looping was an eye-opener for me. The algorithm automatically adjusted my insulin delivery, so I didn’t have to focus on it as much. That made me realize that I had been paying too much attention to my diabetes and not enough to the important things, like family, friends, and personal self-care. Once I grew accustomed to the freedom and customization of Loop, I no longer wanted to go back to open loop pump therapy. This was even despite the drawbacks – needing to keep the Riley Link and my iPhone close to me at all times, charging the Riley daily, and having to enter occasional changes to the computer coding.
When the FDA approved Tandem’s Control-IQ and people started sharing their results, my curiosity got the best of me. Control-IQ is an automated insulin delivery system that combines the t:slim X2 insulin pump, the Dexcom G6 CGM, and an algorithm built into the pump that adjusts basal insulin delivery and gives small automatic correction boluses.
People who were Looping switched to Control-IQ in droves, since they were seeing similar glucose results to Loop but with an FDA-approved device. I talked to a few friends who had switched from Loop to Control-IQ to find out if the system was as amazing as it seemed, and everyone said it was. One friend said that the new system was great but that I might miss a few features like changing the insulin duration and the target ranges.
I found out that Control-IQ did many of the things I wanted in a closed loop system. Click here for a full explanation of features that Control-IQ delivers.
So, I had a dilemma. With Loop I enjoyed the freedom of no pump tubes and the options to customize my pump settings to my needs. Loop’s aggressive algorithm practically took care of everything – if I under-bolused, the algorithm fixed it. When it was working well, it gave me freedom and a higher Time in Range than ever before in my 17 years of diabetes.
On the other hand, it was hard to keep my phone with me at all times, and I sometimes lost signal between the Riley Link and my iPhone. And because Looping is off-label, without FDA approval, there is no customer support other than a Facebook group of users. I realized that I was willing to use a tubed pump if it would help increase my Time in Range, and that having a system that was FDA-approved with an official customer service policy and warranty mattered to me.
I made the switch in August 2020. To be honest, the Control-IQ training for the new tubed pump was not as hard as I feared. The trainer was great, and she walked me through each step over video, including how to input my information and how to read and access my data reports.
It took me a few months to achieve the results I wanted with Control-IQ. At first I experienced less Time in Range than when I was Looping and had trouble setting the exercise feature. I grew frustrated and almost gave up. But after a month or so, I figured out I was not feeding Control-IQ the correct carbohydrate data. Once I got past my carb glass ceiling (read about my experience with carb counting here!), I felt like the pump and I began to work well together. I also created different pump profiles to help with glucose management during exercise and vacation. Together, these changes helped to increase my Time in Range.
I soon identified my favorite features of Control-IQ:
its ability to deliver a micro bolus when the algorithm predicts that my glucose levels will be above 180 mg/dl in the next 30 minutes,
a sleep mode that targets a glucose range of 110 mg/dL-120 mg/dl, and
a safety feature that prevents me from accidently giving myself an extra dose of insulin.
Every once in a while, I miss the aggressive algorithm of the Loop system – which fixed more things and was more forgiving – but I’m glad I made the switch. Since Control-IQ is approved for commercial use, I can call customer service and have more peace of mind. I’ve come to appreciate the consistent, additional support in my diabetes management.
Over the past six months, I have learned that the key to using Control-IQ is making sure the system has all of the right information: insulin to carb ratio, basal and bolus settings, and the correct number of carbs. My trainer is also available, so I do not have to do it alone. Is Control-IQ the perfect solution? I am not sure, but right now it’s right for me.
This article is part of a series on Time in Range.
The diaTribe Foundation, in concert with the Time in Range Coalition, is committed to helping people with diabetes and their caregivers understand Time in Range to maximize patients' health. Learn more about the Time in Range Coalition here.